NPIMap

Individual provider Active NPI

Edwin Kim King, DO

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1033180484
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2534 Issued in OK
Practice address
3212 SW 89TH
Suite 100
Oklahoma City, OK 73159-7907
Phone
(405) 378-3300
Fax
(405) 378-3993
NPI assigned
Feb 1, 2006
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2534 OK Primary

Addresses

Primary practice location

3212 SW 89TH
Suite 100
Oklahoma City, OK 73159-7907

Mailing address

3212 SW 89TH
Suite 100
Oklahoma City, OK 73159-7907
Phone (405) 378-3300

Other identifiers 2

IdentifierTypeStateIssuer
100200420AMedicaidOK
P00265485OtherOKRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000020 OK Practitioner - Family Practice 3375521917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Physicians Group, LLCGroup PAC ID 8325950603, 107 clinicians

Practice addresses (Care Compare)

10021 S Western Ave
Oklahoma City, OK 73139-2927
Phone (405) 692-9300

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 330-0032

3212 SW 89TH St
Oklahoma City, OK 73159-7957

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
The Physicians Group LLC Family Medicine CurrentSince Jul 1, 2005 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Community Hospital LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients
Retail Clinics, LLC Family Medicine Past Accepting new patients

Locations

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

3212 SW 89th St
Ste 100
Oklahoma City, OK 73159
Phone (405) 378-3300

3212 SW 89th St
Ste 200
Oklahoma City, OK 73159
Phone (405) 378-3300

6922 S Western Ave
Ste 101
Oklahoma City, OK 73139
Phone (405) 631-0483

Interoperability endpoints

  • Direct secure messaging: ekimking@okss.allscriptsdirect.net
  • Direct secure messaging: eking392610@direct.integrisok.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northwest Surgical HospitalOklahoma City, OK, CCN 370192 Hospital Corporate Director Feb 25, 2021
Community HospitalOklahoma City, OK, CCN 370203 Hospital Corporate Director Feb 25, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1033180484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 SW 89TH",
            "address_2": "SUITE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597907",
            "telephone_number": "405-378-3300",
            "fax_number": "405-378-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 SW 89TH",
            "address_2": "SUITE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597907",
            "telephone_number": "405-378-3300",
            "fax_number": "405-378-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "EDWIN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200420A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00265485",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.